Claim total
$159.15
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-05-07
- Stop
- 2026-05-08
The parties
- Patient
- patient Emery Herbert Steuber
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
003012ce-f819-e17b-f84d-7cd902e93110